FALL SESSION 2019 REGISTRATION
To register for lessons, please complete and submit the following by 1st lesson:
1. Signed Teacher’s Studio Policy form (See Studio Policy under More on right menu)
2. Tuition: (See Tuition under More on right menu)
3. Registration form for each student (below).
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Fall Session 2019 Piano Student Registration
Please complete for each student and bring to your 1st lesson.
Student Name: ________________________________Nickname (if any) ___________________
Home Phone: _________Address:
___________________Grade: ____ Age: __ Birthday______
City, State, Zip ________________________________
School:__________________________________________________________
Mother’s Name/Work Phone: __________________ Cell Phone: ____________________
Father’s Name/Work Phone: __________________ Cell Phone: ___________________
In case I need to contact this student’s parent during the day, and neither parent can be reached at home, please provide at least one work email address below.
Mother’s Email: ____________________________________________
Father’s Email: _____________________________________________
Emergency Contact Name: _______________________________________
Emergency Contact Phone: ______________________________________
Student's musical experience (if any):
______________________________________________________________
_______________________________________________________________.
Referred by (if anyone):
______________________________________________________________
